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The History of Blood Donation

To provide context for my often seemingly random topics, I’ve been receiving a lot of emails lately about blood drives hosted by various organizations on campus, and my sister has been classically phone-hounded by the Red Cross for the past week. Don’t get me wrong, I think that the Red Cross is a spectacular organization, but they can be a bit intense with their phone calls. These events made me curious about how blood donation began, so I did a bit of research and thought I’d share.

Bloodletting

In ancient times, the proper balance of the various fluids in the body was considered a key part of good health. The bodily fluids were often called “humors,” and blood was a key fluid to be kept in balance. When a person was sick, the sickness was often attributed to an imbalance of humors, and releasing blood was considered beneficial to re-achieving balance (1).

Long before hollow blood-giving needles of today were invented, the Egyptians would drain blood from individuals by literally cutting them on the arm, neck, foot, or other parts of the body and letting the blood flow freely for a certain amount of time before bandaging the wound. Doctors would prescribe this process, known as “bloodletting,” but barbers would actually carry out the process with similar razor blades used for shaving patrons. The classic red and white striped barber pole was originally used to signify that that barbershop practiced bloodletting (1).

[Personal commentary: It’s a good thing I was not alive during this time because if a doctor prescribed someone slicing me open with a razor blade as a cure for anything at all I would run away screaming and never come back. Seriously, I wonder who willingly subjected themself to this madness!] It was not until the later 1800’s (literally more than 75 years after UNC Chapel Hill had been open to students) that the medical benefit of bloodletting was finally questioned and its use phased out (1).

Blood Transfusions

As early as 1492, when bloodletting was still a common practice, people also began to explore the possibility of transferring blood from one human to another as a way to improve health. Sadly, this exploration began before there was a sound understanding of the circulatory system, so the earliest attempts at transfusions including blood drained from living individuals being poured into the mouth of the sick individual. Highly disturbing, I know. Keep in mind that Dracula wasn’t published until 1897, long after the idea of drinking blood to sustain life apparently already existed (1). Blood circulation was discovered in 1628 by William Harvey (2).

In 1667, two separate successful transfusions of sheep blood to humans were recorded, and in 1818 the first human-to-human transfusion was recorded after it saved the life of a woman who hemorrhaged after giving birth (2). The use of milk and saline transfusions as “blood substitutes” was also attempted in late 19th century, but caused several adverse reactions, as you might expect (2). These transfusions did not involve fancy machinery and needles used for transfusion today; the blood was given to the individuals via several injections. The four blood types (A, B, AB, O) were discovered in 1901—1902, and soon it was understood that transfusions could only occur successfully with matching or compatible blood types or else the body would reject the donor blood via an immune response. By 1907, the blood of donors and recipients was routinely tested and matched (1).

In 1914, a huge step toward blood banking occurred when research showed that adding sodium citrate to blood, mixing it, and then keeping the blood refrigerated prevented the blood from clotting and allowed it to be stored for several days. By 1917, an Army doctor began collecting and storing type O blood in preparation for World War I. Various blood facilities arose throughout the twentieth century, and in 1941, the Red Cross organized a “civilian blood donor service” to collect blood in response to the need from World War II. Incredibly, plastic blood-storing bags were not invented until 1948, but subsequently were a great resource for the blood-banking efforts, which previously relied on bulky vacuum bottles. The Red Cross helped to normalize blood donation to aid wounded soldiers during World War II and had collected more than 13 million pints of blood by 1945 (2).

Originally, many blood banks paid the donors for their blood, but by 1970 the U.S. blood banks transitioned to completely volunteer donor systems. In 1974, the U.S. government yielded to the calls of the Red Cross and established an end to paid donations for transfusion use. By 1978, bags of blood were required to be labeled “volunteer” or “paid” (2). Paid blood donations could only be used for pharmaceutical companies and research purposes in order to diminish motivation for individuals with diseases or circumstances which would prevent them from donating to lie about their medical history in order to receive compensation for their donation.

The development and diagnosis of the first cases of AIDS in the United States occurred in 1981, causing a flurry of caution and concern about blood donation being a source of AIDS transfer. In 1985, the test to identify whether a blood sample was HIV/AIDS positive or negative was developed (1).

Today, many community based blood-donation centers also exist, but the Red Cross continues to be the major player in U.S. blood donation and blood banking because they collect an excess of donated blood in certain areas and then use it to supply hospital blood banks in need around the country (2).

Often, we delete those emails announcing blood drives or ignore the phones calls from the Red Cross asking us to donate and take for granted the hundreds of years it took to establish such a successful medical program that saves countless lives around the world. If you are able and eligible, I encourage you to donate like my awesome sister, who I constantly admire for donating despite being extremely afraid of needles and usually feeling temporarily sick after donating. I am so amazed by and grateful for the immense research required to make blood transfusions a safe and life-saving option for so many people every day!